Euthanasia Society Research Articles

The genealogy of death: A chronology of U.S. organizations promoting euthanasia and assisted suicide.

In the early 20th century, a political movement to secure access to euthanasia and assisted suicide began in the United States. The multitude of organizations associated with this effort has undergone an array of mergers, splits, and name changes, channeled through two progenitor organizations-the Euthanasia Society of America and the Hemlock Society. A few chronologies mapping the metamorphoses of these organizations are available, but they are not accessible in the medical literature. Moreover, they are not comprehensive, lack consistency, and are not rigorously validated. As debates about the legalization of euthanasia and assisted suicide continue, it is important to have a common understanding of the history behind these developments, including recognition of the factors driving these adaptations. In this paper, we offer a comprehensive and definitive history to aid those interested in knowing the roots of these organizations and those that are still active today.

Ōta Tenrei’s defense of birth control, eugenics and euthanasia

ABSTRACT Ōta Tenrei (1900–1985) was a gynecologist, socialist, birth control activist, sexologist, aswell as an advocate of eugenics and euthanasia, who participated in the enactment of the Eugenic Protection Law (1948–1996) and founded the Japan Euthanasia Society (1976, now the Japan Society for Dying with Dignity). Ōta had progressive views onsexuality, women’s rights, and reproduction, especially vocal in hisadvocacy of abortion rights. At the same time, he was an advocate of eugenics and he attempted to legalize euthanasia in Japan, arguing among other reasons that some people were a “burden” on society. This article examines Ōta’s advocacy of seemingly contradictory causes such as abortion, eugenics, and euthanasia. It suggests that first, for Ōta all these causes were progressive, aimed at creating a “better world,” and second, he put an excessive stress on autonomy, disregarding rights of those who lacked it, be itfetus, people in a vegetative state, or the intellectually disabled.

Mercy killing in neurology: The beginnings of neurology on screen (II).

The history of Neurocinema includes neuroethics, and this theme was first used in 2 films released in the 1940s in both Germany and the United States. Ich Klage An (I Accuse) is about "terminal" multiple sclerosis in a young woman and the decision to determine one's own fate. The protagonist anticipates becoming "deaf, blind, and idiotic" and asks her husband to administer a toxic drug dose, which he does. The film disturbingly suggests that the diagnosis of multiple sclerosis is tantamount to a death sentence. Ich Klage An (1941) played during the medical murders era ("Aktion T-4" program) but has few references to National Socialism, except for judges with Nazi emblems on their robes making a brief Nazi salute and a jury chamber with a bust of Hitler. Party leadership agreed that the film made a deep impression, but the intended effect on the viewing public is largely unknown. An Act of Murder (1948) involves another young woman with an inoperable brain tumor. When her condition worsens during a trip, her husband deliberately crashes the car, killing her but surviving himself. A subsequent trial finds that she died of an overdose rather than the crash. The trial judge dismisses the murder charge, but the film argues the morals of mercy killing. These films came out during the Nazi euthanasia program and founding of the Euthanasia Society of America in 1938. The choice of neurologic disease by these filmmakers and scriptwriters to defend euthanasia is remarkable.

From the Euthanasia Society to Physician Orders for Life-Sustaining Treatment

Advances in medical care and increasing prevalence of noncommunicable illnesses such as cardiovascular disease and cancer had raised concerns about respecting the patients' dying wishes as early as 1938, when the Euthanasia Society of America was formed. Many high-profile cases and landmark court decisions later, there are now several ways in which different states regulate the patients' end-of-life wishes. How these laws evolved, how seminal cases and medical and ethical advances helped shape the current state of end-of-life legislation, and how patients-especially those with cancer-began adopting various forms of advance directives will be the topic of this article.

The Modern Art of Dying: A History of Euthanasia in the United States. By Shai J. Lavi Princeton, NJ: Princeton University Press, 2005. Pp. 240. $29.95 cloth.

The Modern Art of Dying: A History of Euthanasia in the United States. By Shai J. Lavi. Princeton, NJ: Princeton University Press, 2005. Pp. 240. $29.95 cloth. As Lavi writes at the beginning of the last chapter of his book, Our study of euthanasia in America began with colonial times, when the word still signified a pious blessed by the grace of God. It continued with the medicalization of in the nineteenth century, which was soon followed by attempts to legalize the hastening of death. The struggle to legalize euthanasia took a radical turn with the founding of the Euthanasia Society of America, when proposals to hasten were applied to handicapped and mentally retarded patients. The final section of this study compared the legalization of euthanasia with two alternative means of actively hastening death: the sublegal act of legal dosing and the supralegal act of mercy killing (p. 163). In his study, awarded the ASA Sociology of Law section book prize, Lavi explains how has moved from to technique, from an experience overseen by a minister and family to one of overseen by doctors and constructed by law. This study charts how medicalization, expertise, and regulation cohere, elevating to a social problem and developing strategies to foreshorten life-or, intervening to allow to occur. Lavi's work represents the best of sociolegal scholarship: it is impressive for its clear conceptualization, its marshalling of an impressive array of historical and cultural evidence, and its lucid, clear, and elegant writing. Lavi convincingly argues that how we die reveals a great deal about how we live. He maps the changing meaning of euthanasia, but rather than asking the expected-how did law and medical technique change the way we die?-Lavi asks, instead, why have law and medical technique come to play important and distinct roles in the way we die? The answer is delivered in three parts. Chapter 1 considers the Colonial way of in America, focusing on the Methodists. For the Methodists, dying was a work of art (p. 39). Death was, in a sense, a part of where the death-bed became a microcosm of Methodist life (p. 39). Methodists were not concerned with the pain of dying, but rather with a death in which pain was overcome (p. 39). Gradually, doctors intervened and, with this, a role conflict emerged between minister and doctor-allowing, as subsequent chapters argue-the emergence of over at the deathbed scene. Chapter 2 considers the emergence of the medical profession and the ways it balanced the contending images/demands of hope and with pain and suffering. …

The modern art of dying: history of euthanasia in the United States

Acknowledgments ix Introduction: The Ethics of the Deathbed: Euthanasia from Art to Technique 1 Chapter One: The Holy Craft of Dying: The Birth of the Modern Art of Dying 14 Chapter Two: Medical Euthanasia: From Aiding the Dying to Hastening Death 41 Chapter Three: Legalizing Euthanasia: The Role of Law and the Rule of Technique 75 Chapter Four: Euthanasia as Public Policy: The Euthanasia Society of America 99 Chapter Five: Lethal Dosing: Technique beyond the Law 126 Chapter Six: Mercy Killing: The Limits of Technique 144 Epilogue: Art and Technique, Death and Freedom 163 Appendix: Mercy Killing: Case History 173 Notes 181 Bibliography 211 Index 223

The Voluntary Euthanasia Society

The Voluntary Euthanasia Society

A Merciful End: The Euthanasia Movement in Modern America

A Merciful End: The Euthanasia Movement in Modern America By Ian Dowbiggin (Oxford: Oxford University Press, 2003) (250 pages; $28.00 cloth) For any nurse who has pondered the dilemmas of end-of-life issues, this book by Ian Dowbiggin adds an historical and timely look at euthanasia, assisted suicide, eugenics, and the right-to-die movement. Although others have examined euthanasia, including Roger S. Magnusson in Angek of Death, who described health-care workers' illicit practices,1 Dowbiggin's book includes more than current-day practice. It is a thorough and thoughtful analysis of the philosophical, cultural, and social underpinnings of America's desire to reduce human suffering from the latter part of the 19th century to the present day. The author adeptly weaves a chronological account of these highly complex issues with personal stories of the historical participants and contextual events. His source material is rich and deep and includes archival records from the Euthanasia Society of America and personal interviews. Darwinism, Christianity, and the Progressive Era were the major influences on the early euthanasia movement in America. The emergence of eugenics as a response to the chaos of the sociopolitical environment at the turn of the century is well documented, as is the tension between traditional views of right and wrong when perceived through the eyes of religion and compared with the emerging knowledge of science. The author contends that there has been a longstanding connection between eugenics and euthanasia. Eugenics was a form a social planning described by Francis Gallon, Darwin's cousin, as a method of improving stock (p. 15). In the early part of the 20th century, it swept through numerous countries, and legislation passed that restricted marriage, curbed immigration, and permitted coercive sterilization of the handicapped. It was especially popular in America until the eugenic policies in Nazi Germany became known. When views of physicians and faith in the ability of medical science diminish in terms of their effectiveness in healing or curing disease, the public interest in euthanasia rises. Although there have been several notorious physicians who have promulgated mercy killing, the American medical community has never openly supported it. The author notes several examples of physicians throughout history who have become celebrities for euthanasia. Dowbiggin suggests that there is a strong relationship between interest and support for euthanasia and social and cultural influences. For example, prior to World War II, mercy killing of physically and mentally deformed infants was supported by 45 percent of Americans. In 1938, the Euthanasia Society of America was founded. Efforts by supporters to legalize euthanasia may have been successful were it not for the response to Nazi atrocities during the war, especially those directed against disadvantaged members of society such as the mentally ill, disabled, and mentally handicapped. …

Ian Dowbiggin, A merciful end: the euthanasia movement in modern America, New York, Oxford University Press, 2003, pp. xix, 250, $28.00 (hardback 0-19-515443-6).

Nick Kemp recently produced a history of the British euthanasia movement ‘Merciful release’ (Manchester University Press, 2002). Now, with this new book by Ian Dowbiggin, we have a companion volume that charts the history of the euthanasia movement in modern America. Opening with the Jack Kevorkian case, Dowbiggin's book has six short chapters. The first charts the history of euthanasia as a concept and a practice from classical Antiquity to the Progressive era. The next, entitled ‘Breakthrough’, covers the period 1920–40, and the establishment of the Euthanasia Society of America (ESA) in 1938. The third chapter, called ‘Stalemate’, surveys the struggles of the ESA with the Roman Catholic church in the years 1940–60. Chapter four, ‘Riding a great wave’, deals with the period between 1960 and 1975, including the reinvention of the ESA with the idea of passive euthanasia in the 1960s. The following chapter, ‘Not that simple’, covers the splits that characterized the 1970s, and the emergence of new populist right to die organizations in the 1990s. The conclusion deals with the 1990s and beyond, a period when many Americans have come to believe that euthanasia or assisted suicide would be bad public policy, and when no conclusive outcome is in sight. Dowbiggin has had privileged access to the files of the euthanasia movement, and he is keen to explode the myths that euthanasia only began in the 1960s and 1970s, and that it should be seen as a triumphalist struggle. Other important themes that emerge from his admirably brief but wide-ranging study include the way that euthanasia intersected with other progressive social causes, such as birth control, abortion, and eugenics. Euthanasia was seen “as a critical component of a broad reform agenda designed to emancipate American society from anachronistic and ultimately unhealthy ideas about sex, birth, and death” (p. 30), but also was bedevilled by perennial fears that mercy killing would be extended to people with disabilities. Dowbiggin shows that support for euthanasia in the 1900s was due more to shifting ideas, attitudes, and social forces than to changes in medical practice and technology. Equally important have been the interchangeable social, biological, economic, and humanitarian justifications that have been advanced in its support. A final theme running through Dowbiggin's history is the tension between public authority and personal autonomy, between paternalism and individual freedom. He ends with the new issues posed by September 11, and concludes that the question of “where does the freedom to die end and the duty to die begin” remains unanswered (p. 177). One of the difficulties faced by Dowbiggin is that he has to contend with a large cast of individuals (Felix Adler; William J Robinson; Charles Francis Potter; Charles Killick Millard; Inez Celia Philbrick; Eleanor Dwight Jones; Joseph Fletcher; and Olive Ruth Russell among others). Similarly, by the 1970s the picture becomes very complex as the movement fractured into numerous smaller organizations with frequent name changes (the Society for the Right to Die; Concern for Dying; the Hemlock Society; Choice in Dying; Partnership for Caring, and so on). Nevertheless Dowbiggin has coped admirably with these problems to produce a thoroughly researched and well-written history that convincingly explains the reasons for the ebb and flow of support for euthanasia, locating these movements within wider national and international contexts. Dowbiggin is unable here to engage with the recently published Kemp volume. However, comparative studies of Britain and America (and elsewhere) would seem one obvious way to provide new perspectives on “society's long struggle to deal with the grim reality of human disintegration that we call death” (p. xiv).

Pro-euthanasia poll challenged

The Voluntary Euthanasia Society (VES) has claimed that a poll shows that nearly a half of those surveyed in the UK would help a terminally ill relative to commit suicide if he/she was suffering unbearably and that the overwhelming majority of people support a change in the law on medically assisted death in ‘the right circumstances’.

A Merciful End: The Euthanasia Movement in Modern America (review)

This book contains many engaging stories about the "euthanasia movement" in the United States. Ian Dowbiggin is at his best in the early chapters (1-4), which chart the course of the movement to the mid-1970s. The Euthanasia Society of America (ESA) is the focus of attention. In the final two chapters (5-6) the author turns to the post-1975 period, without highlighting a particular group or issue.

A new kind of living will

Four years ago, when giving a talk about living wills, I stressed that such wills could express the wish to stay alive with life-prolonging measures for as long as possible. In 1999, I was the Vice-Chairman of the Voluntary Euthanasia Society, and, since then, VES has been gradually developing this idea of a living will that offers a choice. The term living will was first used in 1969 by an American lawyer, Louis Kutner. The document is a ‘will’ in that it states a person's wishes. And, it is ‘living’ because it takes effect before death. In the past, the typical living will (also known as an advance directive, an advance refusal, or an advance statement) has only allowed patients to refuse medical interventions or treatments which were aimed at prolonging or sustaining life. Opponents of living wills have condemned such documents as ‘suicidally motivated refusals of medical treatment’. The VES has now produced a new living will that can be used equally well by those who want medical treatment to be given to prolong their lives for as long as possible. This new document (www.ves.org.uk) demonstrates just how concerned VES is to ensure that all citizens should be able to choose the right treatment options in the event that they lose the mental capacity to be involved, with their physicians, in making such medical decisions about themselves. The essential section of this new living will is the following, in which two specific circumstances are described. One is an ‘Imminently life threatening physical illness from which there is little or no prospect of recovery’, and the other is a ‘Very serious mental impairment with no prospect of recovery together with a physical need for life sustaining treatment’. For both situations, an individual has to choose between ‘I wish to be kept alive for as long as reasonably possible and consent to all appropriate medical treatment’ or ‘I refuse medical treatment aimed at prolonging or artificially sustaining my life. I consent only to medical treatment whose aim is to keep me comfortable and, so far as possible, free from pain. I refuse all other medical treatment’. Another important section of this new variant of the living will allows for the naming of a ‘health care proxy’, where this individual has to sign that he/she agrees to assume this role. In Scotland, health care proxies are known as welfare attorneys and these people are recognized under the Adults with Incapacity (Scotland) Act 2000 as having the legal power to make decisions on someone's behalf in accordance with what that person's specific wishes would have been. In England and Wales, proposals are being discussed that should clarify the legal status of a health care proxy. Who benefits from a person writing a living will? Mainly, of course, it is the patient and we are all patients sooner or later. Then, doctors benefit since they no longer have to guess what a patient would have wanted. And, thirdly, family and friends have documentary evidence of a person's wishes. This living will can generate useful discussions between the person making the will, the general practitioner and the family. Various authorities can be cited in support of living wills, ranging from the Lord Chancellor, Lord Irvine (in 1998, writing that they have ‘full effect in common law’) to the BMA (in 1999, stating that ‘where a patient has lost the capacity to make a decision but has a valid advance directive refusing life-prolonging treatment, this must be respected’). Then, in 2002, the General Medical Council noted ‘Adult patients who have the capacity to make their own decision can express their wishes about future treatment in an advance statement’. In the United States a federal law stipulates that, upon admission to any hospital receiving federal funds, a patient must be asked if a living will has been signed. In Denmark, a centralized computer records the details of everyone who has signed such documents. And, in Israel last year, the Health Ministry accepted a recommendation to have a similar computerized database established in that country. All responsible adults should have made a regular will stating exactly where their financial assets and possessions will go. And, I believe, all medical and nursing personnel should make a living will, setting an example for others to follow, because this could be of great assistance someday to their personal doctors, family and friends.

From the USA

How disappointing to see the Ethics Task Force of the EAPC retreat from the EAPC’s unequivocal opposition to legalizing euthanasia. The Task Force paper appropriately emphasizes respect for autonomy as a goal of palliative care while noting that only a minority of terminally ill cancer patients receive adequate palliative care. Remarkably, the report does not emphasize that the inadequate care results largely from our failure to train physicians in how to provide it. Patient autonomy is an illusion when physicians do not know how to assess and treat patient suffering and the choice for patients becomes continued agony or a hastened death. The more physicians know about palliative care, the less they favor assisted suicide or euthanasia, the less they know, the more they favor it. Between 1994 and 1998, a decline of 50% in the support of American oncologists in their support for assisted suicide from 44.5% to 22.5% and a decline in their support for euthanasia from 22.7% to 6.5% appeared to reflect their greater knowledge of how to facilitate a `good death.’ The Dutch experience demonstrates that euthanasia is not a solution to the lack of knowledge of or access to excellent end-of-life care. Given legal sanction, euthanasia, intended originally for the exceptional case, has become an accepted way of dealing with serious or terminal illness in the Netherlands. Pallia tive care has become one of the casualties, while hospice care has lagged behind that of other countries. In testimony before the British House of Lords, Zbigniew Zylicz, a medical oncologist who is one of the few palliative care experts in the Netherlands, attributed Dutch deficiencies in palliative care to the easier alternative of euthanasia. The Task Force paper cites authoritatively Dutch government sanctioned studies,which have been shown to be flawed and misleading. The report does not cite any of the three independent studies by foreign observers; two of which, conducted after the Dutch government sanctioned studies were completed, highlighted these flaws, while all three were able to demonstrate that guidelines established by the Dutch for the practice of assisted suicide and euthanasia were consistently violated and could not be enforced. 11 For example, over 50% of Dutch physicians indicated a willingness to suggest euthanasia to their patients, which compromises its voluntariness. Sixty percent of Dutch cases are not reported to the authorities, which by itself makes regulation impossible. The most alarming concern to arise from the Dutch studies has been the documentation of several thousand cases a year in which patients who have not given their consent have their lives ended by physicians. About a quarter of physicians stated that they had terminated the lives of patients without an explicit request’ from the patient to do so, and a third more of the physicians could conceive of doing so. The Task Force paper endorses Dutch definitions regarding euthanasia, which have insisted that euthanasia is intrinsically voluntary, that `voluntary euthanasia’ is a redundancy, and that involuntary euthanasia has nothing to do with euthanasia. The evidence indicates that in practice the two are more entwined than the Dutch suggest and the definitions they have adopted serve to conceal that fact. In addition to the thousand deaths from involuntary euthanasia that the Dutch admit take place each year they do not define or count as either euthanasia or involuntary euthanasia the increasing number of deaths (in their last report close to 2000) where physicians gave pain medication with the primary intention of ending the patient’s life. When competent patients consent to such a lethal overdose, most investigators regard that as euthanasia. When competent patients do not consent but are given a lethal dose anyhow, most investigators regard that as involuntary euthanasia. It is with good reason that the Dutch Voluntary Euthanasia Society resists pressure to change its name. Practicing euthanasia appears to encourage physicians to think they know best who should live and who should die, an attitude that leads them to make such decisions without consulting patients. One case presented to me as requiring euthanasia without consent involved a Dutch nun who was dying painfully of cancer. Her physician felt her religion prevented her from agreeing to euthanasia so he felt both justified and compassionate in ending her life without telling her he was doing so. The Dutch have a stake in justifying their euthanasia polices and have lobbied with some success for them. Before EAPC retreats any further, it should insist on Palliative Medicine 2003; 17: 178 /179

“A Rational Coalition”: Euthanasia, Eugenics, and Birth Control in America, 1940–1970

In 1940, at the second annual meeting of the Euthanasia Society of America (ESA), its first president, Charles Francis Potter (1885–1962), rose to give a speech. “Euthanasia, or merciful release from suffering,” Potter declared, “is rapidly emerging from the stage when it was considered merely the obsession of a few left-wing social reformers to the period when it is being recognized as an important social measurein the same class with birth control and eugenics.” Almost thirty years later, at another ESA gathering, clergyman Henry Pitney Van Dusen said much the same thing. “Popular attention centers on the Planned Parenthood movement at the other end of life,” Van Dusen declared, and “[e]uthanasia is concerned with the responsible termination of life. The more we can relate these two movements practically the better, because they are both concerned with the responsible care of human life, one at its beginning and the other at its end.”

To die or not to die?

Do not resuscitate orders, living wills and other end-of-life issues are very emotive areas and can provoke great passion and well-thought out and strongly held views on either side of the debate. Here, the Voluntary Euthanasia Society argues their side of the debate.

Should euthanasia be legalized?

Proponents of the legalization of euthanasia feel that although the hospice movement has improved the care of the dying and eliminated the need in many cases for voluntary euthanasia, it is a human's right to have a choice about the manner of his/her death. Voluntary euthanasia is the ‘final act of care and respect for the autonomous patient’ (Voluntary Euthanasia Society (VES), 1996a).

Law Commission's report makes no provision for dissenting doctors

EDITOR,—There is more to some advance directives than the extension of autonomy by a once competent patient. That of the Voluntary Euthanasia Society, for example, requires that insulin is withheld when required from a signatory who develops presenile dementia. If that advance directive were legally enforceable the doctor would have to give way to a patient's wish to have death brought forward by unreasonable measures. Len Doyal1 does not mention a serious deficiency …

In Britain Fewer Conflicts of Conscience

The thoughtful paper by Campbell and colleagues raises questions in a different context from the practice of hospice and palliative care in the United Kingdom. The debate on the issues of euthanasia and, more recently, physician-assisted suicide, has been going on for many years in this country, as it has in the United States. So far, in spite of the strong lobby of the Voluntary Euthanasia Society, there have been no changes in the law in the United Kingdom. Since 1959 I have been challenged to debate these issues on many occasions and am glad to say that the next generation is now able and ready to respond. Both the Association for Palliative Medicine and the National Council for Hospice and Specialist Care Services of the United Kingdom have recently presented written and oral evidence to the House of Lords Select Committee on Medical Ethics. Endorsed by their membership, their representatives have taken the stand that there should be no change in the law to allow anyone to hasten death. The problem of the different attitudes of hospice teams so carefully presented in the paper by Campbell has not arisen so far. I am also informed that in Scotland, where to assist in suicide is not illegal as it is in England, the question rarely if ever arises and practice there is the same, that is, all help is given to bring relief although not a deliberate hastening of death. At times we may have to involve the principle of double effect, knowing that the adequate control of terminal restlessness or pain may lead to a degree of sedation that in itself may hasten death. This is rare and is always fully discussed with both the patient and the family. It was expressed in his summing up in the Dr. John Bodkin Adams case by Judge Devlin as follows: If the first purpose of medicine, the restoration of health, can no longer be achieved, there is still much for a doctor to do, and he is entitled to do all that is proper and necessary to relieve pain and suffering, even if the measures he takes may incidentally shorten life. This is not because there is a special defence for medical men but because no act is murder which does not cause death. We are not dealing here with the philosophical or technical cause, but with the commonsense cause. The cause of death is the illness or the injury, and the proper medical treatment that is administered and that has an incidental effect on determining the exact moment of death is not the cause of death in any sensible use of the term. But ... no doctor, nor any man, no more in the case of the dying than of the healthy, has the right deliberately to cut the thread of life.[1] Hospice and palliative care teams in this country do not meet patients with unmanageable pain and psychological torment imposed by an illness that is not imminently life threatening. Our experience is that the rare requests of this kind are commonly well within the fifteen stipulated in the act (the patient whose story is quoted in the paper only asked for his life to be ended several days before lapsing into coma). This is as true of our home care patients as it is for those within our in-patient unit (and currently we have between 230 and 250 patients being cared for at home and between 50 and 55 in the hospice wards). I think that hospice teams here possibly have more input in relieving distress than some teams seem to have in the United States, where I understand they are still very much at the bidding of the referring physician. Perhaps our longer experience has led to more successful practice (which has been backed up by a recent study from St. Christopher's Hospice [2]), though in no way do we wish to rest on our laurels. From a personal point of view, I would not judge a patient who took his or her own life and we frequently give patients at home supplies of medication to control their symptoms which they could use in this way. …

Assessing Bioethics Today

During 1992, academic bioethicists celebrated the 30th anniversary of bioethics. Some like to date the origin of modern secular bioethics to the advent of transplant technology that began with kidney transplantation in the early 1960s in the Seattle, Washington, area. This is certainly a good candidate for a starting point. Another might be the work of Joseph Fletcher in the New York area with the Euthanasia Society of America and with clergy training. Still another candidate for the origins of secular bioethics would be the trial of physicians at the University of Virginia for transplanting a kidney at which the same Joseph Fletcher testified. At that trial, the alteration occurred in American law from a definition of death that focused on the cessation of heartbeat to one that focused on the cessation of brain function.

The courts and euthanasia.

Most of us, I think, supposed that the debate over euthanasia (doing something to end a life that could otherwise continue) had been pretty well settled. For a long time a minority favored it and a majority opposed it—at least in principle, although not always in practice. Recent court decisions, however, have thrown the whole question open again, while public opinion polls reflect a marked increase in tolerance, if not positive approval. What follows is a lay discussion of the issue—not legally or medically professional but still, it is hoped, acceptable intellectually.My own role in the ethical defense of euthanasia goes back a long way. I began to expound it in the early 1930s. The British organized a euthanasia society in 1935. The Euthanasia Society of America came three years later. It started out with a petition by 1,776 physicians addressed to the New York State Assembly, which promptly rejected it.